1. Objective the aim of this project was directly addressing a major health problem for Jordan by producing a guideline as a pilot in which the strengths and weaknesses will be identified such that similar future efforts in developing treatment guidelines be planned more efficiently. Jordan spends over 9% of its GDP on healthcare, a relatively high percentage for a lower middle-income country, and 3% of that GDP currently goes towards drugs. Approximately 80% of the Jordanian population is insured. The absence of a streamlined process for the development, implementation, monitoring and regular review of national standards for best clinical practices, may contribute to variation in clinical practice when managing clinical conditions, with implications for equity, health outcomes and efficiency. Furthermore, lack of an informatics system to retrieve or track patient care information, and the lack of a tradition of professional societies, make the production of and adherence to national standards a challenging task. In response to that the Jordanian government has launched a series of national pharmaceutical policy initiatives; in 2008, Jordan became a pilot country for the Medicines Transparency Alliance (MeTA), an initiative sponsored by the UK’s Department for International Development (DFID) and supported the World Health Organisation (WHO) and World Bank (WB). MeTA is an international multi- stakeholder initiative to promote increased transparency in the supply of essential medicines. References: 1. Al-Azzam SI, Najjar RB, Khader YS. Awareness of physicians in Jordan about the treatment of high blood pressure according to the seventh report of the Joint National Committee (JNC VII). European Journal of Cardiovascular Nursing. 2007;223-32. 2. Jordan MeTA Council. Medicines Transparency Alliance National Workplan: Jordan. 2008. Available at http://www.medicinestransparency.org/fileadmin/uploads/Documents/MeTA- Jordan-workplan.pdf 3. World Bank. HNPStats. Available at: http://ddp- xt.worldbank.org/ext/ddpreports/ViewSharedReport?&CF=1&REPORT_ID=10309&REQUEST_TYPE=VIEWADVANCED&HF=N 4. National Collaborating Centre for Chronic Conditions. Hypertension: management in adults in primary care: pharmacological update. London: Royal College of Physicians; 2006. (NICE Clinical Guideline 34) Methodology  Working groups constitution  Clinical question development  Data sources identification  Jordan data requirements  Cost impact analysis Results Phase I Introduction Based on The National Institute for Clinical Excellence (NICE)’s hypertension (HTN) guidelines and economic model as a starting point, Jordanian available data and feedback from local experts with regards to Jordanian physicians and patient practices, resource costs, and quality of life estimates; were integrated and adjusted to local settings ending up with a cost-effective evidence-informed clinical pathway for the management of essential HTN in Jordanian primary care. This was performed in 3 phases: Phase II Phase III  Analysis in UK & Jordan  Groups meetings  Focus group arrangement  NICE economic model adaptation to Jordan  Guideline adaptation  Results  Deliverables Piloting the development of a cost-effective evidence-informed clinical pathway: managing hypertension in Jordanian primary care K Chalkidou*, J Lord*, N Obeidat **, I Alabbadi **, A Stanley*, R Bader **, A Momani **, R O’Mahony*, L Qatami **, D Cutler* * Nice team ** Jordan team Implementing the guideline The Medicines Transparency Alliance Jordan is leading on the implementation of this guideline (www.medicinestransparency.org/meta-countries/jordan)www.medicinestransparency.org/meta-countries/jordan Key steps: ● Multi-stakeholder workshop to raise awareness and get feed back ● Ministry of Health approval ● Establish baseline practice and monitor uptake ● Link with public sector procurement strategy and rational drug use ● Launch national awareness campaign for healthcare professionals and patients ● Set up process for review and update of guideline More work needed: ● Prospective cohort studies to establish key epidemiological parameters in Jordan, including incidence of both hypertension and cardiovascular events in hypertensive patients ● Population surveys to establish the quality of life values for the Jordanian population ● Reliable sources for unit costs of drugs, clinical interventions and services offered in public and private sectors ● Regional and national audit to establish baseline data on resource use and prescribing patterns ● Explore the use of electronic medical records systems to collect data